Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
EBONIE NICOLE JACKSON, PTA
ActiveEBONIE NICOLE JACKSON, PTA is a Occupational Therapist healthcare provider located in HOMEWOOD, Alabama. NPI 1710441522 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapist · HOMEWOOD, AL
Registration Details
- NPI Number
- 1710441522
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 25, 2019 (7.5072347958445 yrs)
- Last Updated
- Jan 25, 2019
- License
-
PTA9250 (AL)
Practice Information
- Address
-
1045 BROADWAY PARK STE 107HOMEWOOD, AL, 352096256Browse AL providers · Browse ZIP 35209
- Phone
- 2055736278
- Fax
- 2055736280
- Primary Specialty
-
Occupational Therapist
225200000X
Other Occupational Therapist Providers in HOMEWOOD, AL
| Name | Credential | NPI |
|---|---|---|
| JEREMY BRADLEY BOWEN | PTA | 1942770128 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.